title: Mediators of longitudinal changes in measures of adiposity in teenagers using parallel process latent growth modeling.
abstract: OBJECTIVE
  The aim of the study was to evaluate mediating effects of energy balance-related behaviors on measures of adiposity in the Dutch Obesity Intervention in Teenagers-study (DOiT).
  
  
  METHODS
  DOiT was an 8-month behavioral intervention program consisting of educational and environmental components and evaluated in 18 prevocational secondary schools in the Netherlands (n = 1,108, baseline age 12.7 years, 50% girls). Outcome measures were changes in body mass index (BMI), waist circumference, and sum of skinfold thickness. Self-reported consumption of sugar-containing beverages and high caloric snacks, active transport to/from school, and screen-viewing behaviors were the hypothesized mediators. Data were collected at 0, 8, 12, and 20 months. For the data analysis, parallel process latent growth modeling was used.
  
  
  RESULTS
  Total sugar-containing beverages consumption mediated the intervention effects on BMI (ab = -0.01, 95%CI = -0.20, -0.001). The intervention group lowered their sugar-containing beverages consumption more than controls (B = -0.14, 95%CI = -0.22, -0.11) and this, in turn, led to smaller increases in BMI. No significant mediated effect by the targeted behaviors was found for waist circumference or sum of skinfolds.
  
  
  CONCLUSIONS
  Future school-based overweight prevention interventions may target decreasing sugar-containing beverages consumption.
authors.affiliation: Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
authors.forename: Mine
authors.initials: M
authors.lastname: Yιldιrιm
authors.forename: Amika S
authors.initials: AS
authors.lastname: Singh
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: te Velde
authors.forename: Maartje M
authors.initials: MM
authors.lastname: van Stralen
authors.forename: David P
authors.initials: DP
authors.lastname: MacKinnon
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Mai J M
authors.initials: MJ
authors.lastname: Chinapaw
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology; D041923:Adolescent Development; D015992:Body Mass Index; D001837:Body Weights and Measures / Q000379:methods; D002648:Child; D002149:Energy Intake / Q000502:physiology; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008954:Models, Biological; D009043:Motor Activity / Q000502:physiology; D050177:Overweight / Q000453:epidemiology / Q000209:etiology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors